Key result
Diabetes was associated with a higher proportion of diseased coronary vessels compared to matched controls (68% vs 46%, P<0.005), but no increase in diffuse or inoperable disease.
Why the study?
Does diabetes mellitus increase the severity, diffuseness, or inoperability of coronary artery disease in patients undergoing cardiac catheterization?
Case-Control (n=116)
Does diabetes mellitus increase the severity, diffuseness, or inoperability of coronary artery disease in patients undergoing cardiac catheterization?
Absolute Event Rate: 68% vs 46%
p-value: p=<0.005
Diabetic patients undergoing cardiac catheterization have a greater overall burden of coronary artery disease compared to matched non-diabetics, but the disease is not significantly more diffuse or inoperable.
Diabetes linked to greater CAD burden without increased diffuseness or inoperability; extends anatomic observations but leaves causal and management implications open.
To compare angiographically-determined coronary artery disease in diabetic patients with controls, 1,653 patients coming to cardiac catheterization were reviewed retrospectively to find 37 diabetic and 79 control patients matched for sex, age (+/- 3 years), and risk factors (hypertension, hyperlipidemia, and smoking). The severity of coronary artery disease was assessed using an angiographic grading system. The following results were obtained: 16 of 37 diabetic patients (43%) had three-vessel disease compared to 20 of 79 controls (25%). Seventy-six of 111 (68%) diabetic vessels were diseased compared to 110 of 237 control vessels (46%) (P less than 0.005). The total coronary score reflecting total extent of disease for diabetic patients was 371 (mean 10.0 +/- (SEM) compared to 594 for controls (mean 7.5 +/- 0.7, (P less than 0.01). Diabetic patients had a statistically similar number of diffusely diseased vessels as controls (28% vs 22%). There were only three of 76 diabetic vessels (4%) considered inoperable compared to seven of 110 (6%) control vessels. We conclude that diabetic patients with chest pain have more coronary artery disease than nondiabetics, but no more diffuse or inoperable disease.
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Dortimer et al. (1978) conducted a case-control in Coronary artery disease (n=116). Diabetes vs. Non-diabetic controls was evaluated on Diseased coronary vessels (p=<0.005). Diabetes was associated with a higher proportion of diseased coronary vessels compared to matched controls (68% vs 46%, P<0.005), but no increase in diffuse or inoperable disease.
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